title: Pulmonary artery perforation by plug anchoring system after percutaneous closure of left appendage.
abstract: Patients receiving oral anticoagulant therapy for atrial fibrillation who are at high risk of bleeding are increasingly referred for percutaneous left atrial appendage exclusion. Although effective, this procedure is not free from risk. We report a case of pericardial tamponade due to pulmonary artery tear caused by a trespassing anchoring hook of an AGA plug. Intraoperatively, no actual bleeding was found from the left appendage, a proof of its complete occlusion by the device. The patient underwent successful surgical repair and radio-frequency ablation of atrial fibrillation was performed by pulmonary veins encircling.
authors.affiliation: Department of Adult Cardiac Surgery, Ospedale del Cuore G. Pasquinucci, Fondazione Toscana G. Monasterio, Massa, Italy; Scuola Superiore Sant'Anna, Settore Scienze della Vita, Pisa, Italy. gbianchi@ftgm.it
authors.forename: Giacomo
authors.initials: G
authors.lastname: Bianchi
authors.forename: Marco
authors.initials: M
authors.lastname: Solinas
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gasbarri
authors.forename: Stefano
authors.initials: S
authors.lastname: Bevilacqua
authors.forename: Kaushal Kishore
authors.initials: KK
authors.lastname: Tiwari
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
authors.forename: Mattia
authors.initials: M
authors.lastname: Glauber
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D012421:Rupture; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D053441:Suture Anchors / Q000009:adverse effects*